Key result
Mapping the transseptal track using the Carto3 system significantly reduced the time to cross the interatrial septum compared to fluoroscopy (4±3 s vs. 20±10 s, p<0.01) and eliminated radiation exposure.
Why the study?
Does crossing the interatrial septum guided by 3D mapping reduce procedure time and fluoroscopy use compared to fluoroscopy guidance in patients with persistent atrial fibrillation?
RCT (n=40)
Open-label
1:1
No
Does crossing the interatrial septum guided by 3D mapping reduce procedure time and fluoroscopy use compared to fluoroscopy guidance in patients with persistent atrial fibrillation?
Absolute Event Rate: 4% vs 20%
p-value: p=<0.01
Using a 3D mapping system to guide catheter crossing of the interatrial septum significantly reduces procedure time and eliminates fluoroscopy use compared to traditional fluoroscopic guidance.
Shortens transseptal crossing time and eliminates fluoroscopy in AF ablation; supports routine adoption of 3D mapping guidance.
OBJECTIVE: To investigate whether switching the ablation catheter between the right and left atria through transseptal puncture site can be accurately performed without fluoroscopy. METHODS: Forty patients with persistent atrial fibrillation (mean age, 60.2±7.4 years; 65% males) got "2C3L" approach were randomized in a 1:1 ratio to undergo either crossing interatrial septum guided by fluoroscopy (trackless group) or crossing septum guided by track image that was mapped by Carto3 system (track group). RESULTS: The three-dimensional image of the track could be mapped smoothly and shown clearly. No significant differences were found in the success rates between the two groups (100% vs. 100%, p>0.05). However, the procedure of crossing septum was completed without any fluoroscopy use in track group, which showed a shorter procedure time than trackless group (4±3 s vs. 20±10 s, p<0.01). CONCLUSION: Visualizing the track passing through the puncture site using Carto3 system can guide the ablation catheter in safely crossing the intra-atrial septum quickly with zero fluoroscopy.
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Yuan Yuan (2017) conducted an RCT in Persistent atrial fibrillation (n=40). 3D track image mapping using Carto3 system (fast anatomic mapping) vs. Fluoroscopy guidance was evaluated on Procedure time for crossing the interatrial septum (seconds) (p=<0.01). Mapping the transseptal track using the Carto3 system significantly reduced the time to cross the interatrial septum compared to fluoroscopy (4±3 s vs. 20±10 s, p<0.01) and eliminated radiation exposure.
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